Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound   Target Concepts: Gene/Protein Disease Symptom Drug Enzyme Compound

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Query: UMLS:C0264733 (ventricular dilatation)
2,163 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Quantitative radionuclide angiography (with the first pass technique and a computerized multicrystal camera) was used to evaluate hemodynamic changes in three subject groups during symptom-limited upright exercise. The 12 normal subjects had significant increases in heart rate, stroke volume, left ventricular ejection fraction and cardiac output during exercise; changes in end-diastolic and end-systolic volumes were not significant. In the 24 patients with coronary artery disease there were significant increases in heart rate and cardiac output during exercise, but insignificant changes in end-diastolic, end-systolic and stroke volumes and ejection fraction. The change in diastolic volume in these patients was determined by the extent of coronary artery disease, propranolol therapy, end point of exercise and presence of collateral vessels. Furthermore, patients with previous myocardial infarction had a lower ejection fraction and higher end-diastolic and end-systolic volumes during exercise than those without myocardial infarction. In the 12 patients with chronic aortic regurgitation of moderate to severe degree, there was a decrease in the end-diastolic volume during exercise. This response was distinctly different from that of the normal subjects or the patients with coronary artery disease. All three groups had a significant decrease in pulmonary transit time during exercise. It is concluded that changes in cardiac output in normal subjects during upright exercise are related to augmentation of stroke volume and tachycardia, whereas in patients with coronary artery disease they are related mainly to tachycardia. Left ventricular dilatation during exercise occurred in some normal subjects and in patients with coronary artery disease but was not a consistent finding. However, a decrease in left ventricular end-diastolic volume is common in patients with aortic regurgitation. Such a decrease may be explained by a reduction in the regurgitant volume per beat caused by shortening of the diastolic filling period or a decrease in systemic vascular resistance, or both.
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PMID:Quantitative radionuclide angiography in assessment of hemodynamic changes during upright exercise: observations in normal subjects, patient with coronary artery disease and patients with aortic regurgitation. 626 23

The index of valvular regurgitation was measured by two techniques after technetium 99 m gamma-cineangiography: the classical technique of comparing left and right ventricular stroke volumes, and the same technique after subtracting the radioactivity arising from the right atrium from the zone of right atrioventricular superposition. The index of valvular regurgitation was calculated in 41 patients with chronic coronary artery disease without valvular regurgitation and also undergoing coronary angiography with 30 degrees right anterior oblique ventriculography, in 8 healthy volunteer subjects, at rest and on exercise; and in 15 patients with chronic aortic regurgitation also undergoing cardiac catheterization and 30 degrees right anterior oblique left ventriculography and aortography. The regurgitant index by the classical technique was 1,25 +/- 0,18; when the index was calculated again after subtracting right atrial radioactivity, a value of 1,05 +/- 0,12 (p less than 0,01) was obtained. The regurgitant index is not affected by left ventricular contractility or by the degree of left ventricular dilatation. On the other hand, this index is affected by the degree of right ventricular dilatation. The valvular regurgitant index did not vary significantly on exercise (1,01 +/- 0,11 to 1,17 +/- 0,16 NS). The isotopic regurgitant fraction deduced from the valvular regurgitant index correlated well with the angiographic regurgitant fraction (R = 0,74; p less than 0,001). The index of valvular regurgitation gives an exact, reliable and reproducible quantification of left sided regurgitant lesions. It is only valid when there is no intracardiac shunt or regurgitant right heart lesion.
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PMID:[Method of isotopic determination of aortic valve regurgitation]. 643 69

The present study deals with the factors affecting the prognosis in the acute stage of 29 cases with hypertensive thalamic hemorrhage diagnosed by CT scan. It was thought that the following factors were significantly related to the outcome of the patients who were unable to lead daily life, remained in vegetative state or died: (1) consciousness level was below 10 in the so-called 3-3-9 formula, (2) bilateral Babinski's signs were observed, (3) localization of the hematoma was all the thalamic nuclei type, (4) hematoma volume was above 10 ml, (5) the maximum dimension of hematoma was over 30 or 35 mm, maximum width over 30 mm, maximum length over 25 mm and maximum height over 30 or 40 mm, and (6) the ventricles were dilatated. The prognosis had no significant relationship with the age of the patients, the side of the hematoma, the presence or the absence of ventricular penetration of the hematoma, or the existence of midline shift. We believe that in the acute stage of hypertensive thalamic hemorrhage, the prognosis can be forecasted by neurological findings, accurate calculation of the hematoma volume and size, localization of the hematoma and presence or absence of ventricular dilatation as determined by CT scan.
Stroke
PMID:Factors affecting the prognosis in thalamic hemorrhage. 660 70

Cardiovascular function and structure were evaluated by M-mode echocardiography and systemic hemodynamics in paired lean and obese patients, either hypertensive or normotensive. Compared to lean patients, obese patients had greater left atrial (p less than 0.0001), ventricular (p less than 0.001), and aortic root (p less than 0.002) diameters; posterior and septal wall thickness (p less than 0.001); and ventricular mass, cardiac output, stroke volume, and stroke work (all p less than 0.0001). Hypertensive patients had increased posterior wall thickness, end diastolic wall stress, stroke work (p less than 0.01), and a lower radius to posterior wall thickness ratio indicating concentric hypertrophy (p less than 0.001) when compared to normotensive patients. Cardiac adaptation to obesity consists of left ventricular dilatation and hypertrophy (eccentric hypertrophy) irrespective of arterial pressure levels. In contrast, essential hypertension solely produces concentric hypertrophy. Both obesity and hypertension increase left ventricular stroke work by disparate hemodynamic mechanisms; their presence in the same patient will tax the heart and increase the long-term risk of congestive failure.
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PMID:Dimorphic cardiac adaptation to obesity and arterial hypertension. 665 Oct 22

This study set out to determine the pathophysiologic changes in the left ventricle during atrial pacing in 22 patients with coronary artery disease. Graduated right atrial pacing to a rate of 160 beats/min, or the induction of angina pectoris or significant ST depression was undertaken. Ventricular volumes were measured at rest and at rates of 100, 120, 140 and 160 beats/min using radionuclide angiography. The volumes at a pacing rate of 100 beats/min were used as a reference standard (100%). In the 22 patients with coronary artery disease, left ventricular end-diastolic volume decreased from 118 +/- 3% at rest to 80 +/- 5% at a rate of 160 beats/min; stroke volume from 121 +/- 3% to 54 +/- 5%; and ejection fraction (EF) from 49 +/- 3% to 37 +/- 5%. End-systolic volume decreased from 118 +/- 4% at rest, reached its minimal value of 94 +/- 5% at a rate of 120 beats/min and then increased slightly to 106 +/- 9% at 160 beats/min. Cardiac output and blood pressure did not change significantly. Compared to the control group of 10 normal subjects, the patients had a significantly smaller decrease in end-diastolic volume and end-systolic volume than in normal control subjects. EF in the normal subjects did not change. Blood pressure, cardiac output and stroke volume were similar in both groups. Atrial pacing tachycardia induced reversible ventricular dysfunction with a decrease in EF. Stroke volume was maintained because of relative ventricular dilatation.
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PMID:Left ventricular volumes and function during atrial pacing in coronary artery disease: a radionuclide angiographic study. 669 79

The Frank-Starling mechanism was investigated in 88 athletes exposed to physical stress and was shown to operate under physical stress in athletes with ventricular cavities of normal or moderately increased size. In athletes with physiological ventricular dilatation as a result of endurance training (over 160 ml in ultimate diastolic volume), the Frank-Starling mechanism is not normally triggered under stress: increased cardiac output is provided by greater basal blood volume reserve. With ultimate diastolic volumes of 115-159 ml, the Frank-Starling mechanism provides an optimum increase in peak stroke volume. The effectiveness of the heterometric mechanism activated by physical stress in subjects with small ultimate diastolic volumes is not sufficient as additive reserve volume cannot be increased essentially.
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PMID:[Efficacy of the Frank-Starling mechanism during physical stress]. 688 71

We studied 9 men with antero-apical left ventricular aneurysms. All suffered from incapacitating angina pectoris without heart failure. Aneurysmectomy was done in 4 patients as the sole procedure while it was combined with revascularisation of the residual myocardium in the other 5. Haemodynamic measurements were made at rest and during submaximal supine-leg exercise before and approximately 6 mth after operation in each patient. Compared to the preoperative levels, we observed a significant increase in respiratory rate at rest (P less than 0.001) and during exercise (P less than 0.01), in ventilation during exercise (P less than 0.05), in mean pulmonary arterial pressure at rest (P less than 0.001) and during exercise (P less than 0.01) and in mean pulmonary wedge pressure during exercise (P less than 0.01). These changes were accompanied by a significant reduction in cardiac output during exercise (P less than 0.01) and in stroke volume at rest (P less than 0.05) and during exercise (P less than 0.01). Heart rate and blood pressure remained essentially unchanged. . The curve representing the relationship between the left ventricular stroke work and the filling pressure shifted downwards and to the right after operation compared to that before operation. Patients who show only minimal haemodynamic disturbances associated with an aneurysm, maintain an effective forward stroke volume by an augmented fibre-shortening of the residual myocardium as well as an increase in the diastolic volume of the heart. Results of our study demonstrated that the compensatory ventricular dilatation may be critical in this group of patients. Despite an increase in average ejection fraction after operation, the removal of the aneurysm led to considerable haemodynamic deterioration in all the patients studied.
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PMID:Left ventricular aneurysm: pre- and postoperative haemodynamic studies at rest and during exercise. 728 25

Seven patients (3 men, 4 women; age 15-48 years) from 6 families with mitochondrial encephalomyopathies were studied. There were 4 patients with mitochondrial myopathy, encephalopathy, lactic acidosis and stroke-like episodes (MELAS) and 3 patients with myoclonus epilepsy and ragged-red fibers (MERRF). The clinical course was variable in both MELAS and MERRF patients. Interestingly, one MERRF patient had putaminal hemorrhage with left hemiplegia. In MELAS patients, brain computed tomography (CT) revealed cerebral hypodensity lesions affecting all four lobes and relative sparing of the basal ganglia and the thalamus. The CT of MERRF patients showed cerebral and cerebellar cortical atrophies in two and ventricular dilatation in one. During the recovery stages, magnetic resonance images (MRI) revealed subcortical white matter lesions in two MELAS patients and one MERRF patient. These subcortical white matter lesions were most prominent in the paraventricular areas. The present data indicate that in MELAS the hypodense lesions tend to affect the cerebral hemisphere and to spare the subcortical gray matter. Furthermore, the involvement of the paraventricular white matter may occur in both MELAS and MERRF.
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PMID:Mitochondrial encephalomyopathies: CT and MRI findings and correlations with clinical features. 767 79

To estimate the relationship between aging, dementia and changes observed on magnetic resonance imaging (MRI) seen in elderly patients with cerebral thrombosis, MRI findings in 103 patients with an initial stroke event (thrombosis group) were compared with those of 37 patients with hypertension/diabetes (high risk group) and 78 patients without those disorders (low risk group). In addition to the causative lesions in the thrombosis group, periventricular hyperintensities (PVH), spotty lesions (SL), silent infarctions (SI), ventricular dilatation (VD), and cortical atrophy (CA) were analyzed in these groups. Infarctions located in the internal capsule/corona radiata were the most frequent causative lesion. Compared to the low risk group, a high incidence of patchy/diffuse PVH, SI, and severe CA was seen in both the thrombosis group and the high risk group. Widespread PVH and multiple SL increased with age in the thrombosis group, while severe CA was seen in each group. SI and VD tended to increase after age 60, though they were not significant. Dementia, diagnosed in 40 out of 78 patients, increased with age. Multivariate analysis revealed the degree of the effects of MRI findings on dementia to be marked in PVH, brain atrophy, causative lesions, and SL, in that order. These results indicated that diffuse PVH and brain atrophy, developing with age, promoted dementia in the elderly with vascular lesions. Moreover, they suggested that a variety of silent brain lesions recognized on MRI other than infarction can affect symptoms in the elderly.
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PMID:[Brain MRI findings in patients with initial cerebral thrombosis and the relationship between incidental findings, aging and dementia]. 772 91

Right ventricular function was measured in ten patients with severe COPD (mean FEV1 = 0.48 +/- 0.2 L/s) as part of an evaluation for single lung transplant (SLT). Right ventricular ejection fraction (RVEF) was determined by two methods: first-pass radionuclide scan by multigated acquisition (MUGA) and by using a fast thermistor tipped RVEF/volumetric pulmonary artery catheter. None of the patients had clinical evidence of active right heart failure, although mild resting pulmonary hypertension (mean pulmonary artery pressure [PAP] = 24 +/- 4 mm Hg) that worsened with minimal exercise (mean PAP = 39 +/- 11 mm Hg) was present. There was a significant difference in RVEF measured by the two methods (mean MUGA RVEF = 57 +/- 10%, mean catheter RVEF = 27 +/- 8%; p < 0.00005). RVEF determined by both methods was correlated with hemodynamic and gas exchange variables obtained during rest and at maximal exercise. There were significant, yet inverse, correlations between RVEF measured by catheter and cardiac index measured during exercise (CIex), as well as with exercise pulmonary vascular resistance index (PVRI). There were no significant correlations found between MUGA RVEF and any gas exchange or hemodynamic variables. Significant correlations were found with the catheter-measured right ventricular end-diastolic volume (RVEDV) and CIex (r = 0.9 p < 0.005), with maximal oxygen consumption during exercise (VO2max) (r = 0.86 p < 0.0025), with exercise stroke volume index (SVI) (r = 0.76 p < 0.01), and exercise central venous pressure (CVP) (r = 0.62 p < 0.05). Echocardiographic studies revealed right ventricular dilatation and mild tricuspid regurgitation (TR) in all patients. The strong correlation between RVEDV, CIex, and VO2max supports the concept that in these patients, as long as there is no clinical evidence of right heart failure (resting CVP still within normal limits), those with the largest RVEDVs use the Frank Starling principle to their best advantage to remain more functional.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Right ventricular function in patients with severe COPD evaluated for lung transplantation. Lung Transplant Group. 778 38


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